Elective laparoscopic cholecystectomy - Treatment of choice for cholelithiasis in children with sickle cell disease?

Background: Gallbladder stones are very common in patients with sickle cell disease and are the cause of recurrent abdominal pain. Their management ha s been highly controversial, especially for children. Nonoperated patients and those treated on an emergency basis have a very high rate of morbidity (>50%). Methods: We performed a retrospective review of a series of 29 homozygous S S sickle cell children who underwent laparoscopic cholecystectomy between 1 991 and April 1998. Results: Only in one case a conversion was necessary (early in the series). Exploration of the common bile duct was done via intraoperative cholangiog raphy. There were no mortalities. The morbidity rate was 17%; (however, of the five patients concerned, four suffered from hyperthermia for 2 days). A ll of the children were improved and enjoyed resolution of their abdominal pain. Conclusions: We believe that elective laparoscopic cholecystectomy at the e arliest time possible, along with correct perioperative management, is the treatment of choice for cholelithiasis in children with sickle cell disease .